Common complaints by physicians on OPPE data

Physicians may claim that the data used to carry out peer review is invalid. This is a claim that many medical staff leaders have heard. It is true that the discovery of even the slightest inaccuracy will invalidate the entire performance report in the minds of some physicians. They will assume, and no one would blame them, that if the report includes one inaccuracy it is likely that there are addi­tional inaccuracies. Following are some claims often heard from physicians regarding accuracy of performance data:

• Attribution (“It’s not my patient.”): Accuracy of attribution is critical to the credibility of the peer review process. If a question is being raised about the quality of care delivered, it is important that the correct practitioner is identified. For example, a patient may have a surgi­cal procedure by a gynecologist and then be transferred to an internist for continued medical care in the hospital. If there is a question about a direct complication from the surgical pro­cedure itself, the gynecologist should get the query, not the internist.
• Risk adjustment (“My patients are sicker!”): The use of severity-adjusted data when avail­able can help halt this objection at the start. Likewise, using national benchmarks, even if imperfect, is often better than some in-house-defined standard.
• Sample size (“The ‘n’ isn’t big enough.”): Sometimes we need to remind our colleagues that measuring performance is not the same as conducting a statistical study. If the physician follows national practice guidelines and delivers high-quality care to eight out of 10 patients, the concern should not be whether “n” is sufficient. The concern is that the phy­sician did not deliver the best practice care to two of the 10 patients.

Source: The Medical Staff Leader's Survival Guide